ENFORCEMENT DECREE OF THE MEDICAL INSURANCE ACT

Article 1(Purpose) #

The purpose of this Decree is to prescribe the matters delegated by the Medical Insurance Act (hereinafter referred to as the “Act”) and matters necessary for its enforcement.

Article 2(Money and Other Valuables not Included in Remuneration) #

The money and other valuables not included in remuneration pursuant to the proviso of subparagraph 4 of Article 3 of the Act shall be as follows:

1. Retirement allowance;

2. Educational expenses;

3. Bonuses: Provided, That in the case of financial need on the part of the medical insurance association (hereinafter referred to as the “association”), the operating committee of the association concerned may resolve to include a bonus in remuneration;

4. Prize money, translation fees and remuneration for writing;

5. Day duty allowances, night duty allowances, transportation expenses and travel expenses;

6. Compensation money and holiday work allowances granted pursuant to the provisions of the Labor Standards Act and other Acts and subordinate statutes, and overtime allowances and night shift allowances granted at irregular intervals;

7. Social insurance benefits granted pursuant to the provisions of any Acts and subordinate statutes;

8. Meals and meal subsidies offered to employees employed in the workplace, and uniforms, working uniforms, regulation caps and shoes provided to employees;

9. Allowances specially paid to employees employed in the workplace as compensation for the disadvantages or dangers resulting from the peculiarities of the work area or work post;

10. Prize money or reward granted pursuant to the provisions of any Acts and subordinate statutes or Municipal Ordinances;

11. Daily wages, allowances or travel expenses, etc. paid in accordance with the number of attendance days to members who have not received remuneration pursuant to the provisions of any Acts and subordinate statutes or Municipal Ordinances; and

12. Expediency fund and other monies and valuables granted extraordinarily.

Article 3(Persons Excluded from Category of the Insured) #

(1) Pursuant to the proviso of Article 4 (1) of the Act, the employees excluded from the category of the insured shall be the following:

1. Employees working in the workplace where less than five ordinary employed workers are hired: Provided, That workers working in the workplace which falls under one of the following items shall be excluded:

(a) A workplace which has occupied an industrial complex designated or created and managed under the Industrial Placement and Factory Construction Act and the Industrial Sites and Development Act, or a free export zone designated under the Act on the Establishment of Free Export Zones (hereinafter referred to as the “industrial complex”); and

(b) Pursuant to the provisions of Article 18 of the Act, the workplace deemed as the workplace eligible for medical insurance under the provisions of Article 4 (1) of the Act;

2. Workers working in the workplace of a foreign organization residing in Korea where less than five ordinary employed workers of Korean nationality are hired;

3. Persons who are beneficiaries of the medical care pursuant to the Medical Care Act;

4. Persons who are beneficiaries of the medical care pursuant to the Act on the Honorable Treatment of Persons of Distinguished Services to Independence or the Act on the Honorable Treatment and Support of Persons, etc. of Distinguished Services to the State: Provided, That persons who intend to be covered by medical insurance under this Act shall be excluded;

5. Daily employed workers: Provided, That where a worker is employed for a period of more than two months, it shall not apply;

6. Workers who are employed for a specific period of not more than two months: Provided, That where a worker is employed for a period of more than two months, it shall not apply;

7. Workers working in a workplace of which the domicile is unclear;

8. Workers who are employed for seasonal or temporary workplaces; and

9. Persons who are not employed on a full-time basis, such as part-time advisers or part-time workers.

(2) Despite the provisions of paragraph (1), where several business places are under relationships of main office, branch office, agency office, and dispatched office, and the managements of business are unified, those shall be regarded as a single workplace in the application of paragraph (1) 1 and 2: Provided, That where they fall under one of the following subparagraphs, it shall not apply:

1. Workplaces which have occupied an industrial complex; and

2. A workplace which is operated in separation from a head office in terms with the standards for personnel management and salary payment and thus treated separately by the Minister of Health and Welfare.

[This Article Newly Inserted by Presidential Decree No. 15918, Oct. 17, 1998]

Article 3-2(Medical Insurance Cover for Persons of Distinguished Services to State, etc.) #

(1) Where a person who is the beneficiary of medical care pursuant to the Act on the Honorable Treatment of Persons of Distinguished Services to Independence or the Act on the Honorable Treatment and Support of Persons, etc. of Distinguished Services to the State intends to be covered by medical insurance pursuant to the proviso of Article 3 (1) 4, he shall make a report to the appropriate association. <Amended by Presidential Decree No. 14506, Dec. 31, 1994; Presidential Decree No. 15486, Sep. 30, 1997; Presidential Decree No. 15918, Oct. 17, 1998>

(2) Where the person who has been covered by medical insurance becomes the beneficiary of medical care as prescribed in the Act on the Honorable Treatment of Persons of Distinguished Services to Independence or the Act on the Honorable Treatment and Support of Persons, etc. of Distinguished Services to the State, he shall report to the affiliated association as to whether or not he will continue to the beneficiary of medical insurance. In cases where he does not make a report, he shall be regarded as being covered by medical insurance as prescribed in the proviso of Article 3 (1) 4. <Amended by Presidential Decree No. 14506, Dec. 31, 1994; Presidential Decree No. 15486, Sep. 30, 1997; Presidential Decree No. 15918, Oct. 17, 1998>

Article 4(Time, etc. of Disqualification of Persons of Distinguished Services to State, etc. as Insured) #

The person who has made a report to the effect that he will no longer be covered by medical insurance pursuant to the provisions of Article 3-2 (2), shall be disqualified as the insured on the day following the day on which he made the report: Provided, That a person who made the report within 14 days from the day on which he became the beneficiary of medical care pursuant to the Act on the Honorable Treatment of Persons of Distinguished Services to Independence or the Act on the Honorable Treatment and Support of Persons, etc. of Distinguished Services to the State, shall be disqualified as the insured on the day on which he became a beneficiary of medical care. <Amended by Presidential Decree No. 14506, Dec. 31, 1994; Presidential Decree No. 15486, Sep. 30, 1997; Presidential Decree No. 15918, Oct. 17, 1998>

Article 5(Functions of Deliberative Committee) #

The Medical Insurance Deliberative Committee (hereinafter referred to as the “Deliberative Committee”) as prescribed in Article 5 (3) of the Act shall provide advice and suggestions at the request of the Minister of Health and Welfare with respect to the following matters: <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

1. Matters concerning the medical insurance system;

2. Matters concerning the insurance benefits;

3. Matters concerning the premium; and

4. Other matters submitted by the Minister of Health and Welfare with respect to medical insurance.

Article 6(Composition of Deliberative Committee) #

The Deliberative Committee shall be composed of the following members:

1. Two members representing the insurers;

2. Four members representing the insured;

3. Two members representing the employers;

4. Eight members representing the medical and pharmaceutical circles; and

5. Five members representing the public interest.

Article 7(Appointment or Commissioning of Members) #

The members of the Deliberative Committee shall be appointed or commissioned by the Minister of Health and Welfare according to the following classifications: <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

1. Members representing the insurers: persons recommended by the insurers’ organization;

2. Members representing the insured: two persons recommended by the organization of labor unions, one person recommended by the organization representing farmers and fishermen, one person recommended by the consumers’ organization;

3. Members representing the employers: persons recommended by the employers association;

4. Members representing the medical and pharmaceutical circles: persons recommended by the organization representing the medical and pharmaceutical circles; and

5. Members representing the public interest: the public officials concerned and persons with great knowledge and experience in relation to medical insurance.

Article 8(Tenure of Members) #

The term of office of members shall be two years: Provided, That in the case of a member who is a public official, the term shall be his tenure of office, and the tenure of a supplementary member shall be the remainder of his predecessor’s term.

Article 9(Chairman, etc.) #

(1) One chairman and one vice-chairman respectively shall be assigned in the Deliberative Committee.

(2) The Vice Minister of Health and Welfare shall be the chairman of the Deliberative Committee; the vice-chairman shall be mutually elected from among the members representing the public interest. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(3) The chairman shall represent the Deliberative Committee and preside over the business of the Deliberative Committee.

(4) The vice-chairman shall assist the chairman and, in case of accident to the chairman, the vice-chairman shall execute those duties on his behalf.

Article 10(Meetings) #

(1) The chairman shall convene meetings of the Deliberative Committee and act as chairman.

(2) Meetings of the Deliberative Committee shall be convened where the Minister of Health and Welfare requires it, where the majority of members of the Deliberative Committee require it or where the Chairman deems it necessary. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(3) The meeting of the Deliberative Committee shall open upon the attendance of the majority of members and shall issue resolutions with the consent of the majority of members present.

Article 11(Report) #

The chairman shall report the matters resolved by the Deliberative Committee to the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 12(Secretary) #

(1) One secretary shall be assigned in the Deliberative Committee; he shall be appointed by the Minister of Health and Welfare from among the public officials under his authority. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) The secretary shall manage the general affairs of the Deliberative Committee upon the orders of the chairman.

Article 13(Allowance) #

The members who attend the Deliberative Committee may be paid an allowance within the limits of the budget: Provided, That this shall not apply in cases where a member who is a public official attends a meeting directly in connection with his official business.

Article 14 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 15 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 16 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 17 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 18(Period for Application for Authorization of Establishment of Association) #

(1) The period for application for authorization of the establishment of an association which is to be established by the employer of a workplace which employs persons covered as the compulsory insured pursuant to Article 16 (1) of the Act, shall be no more than three months from the date on which the workplace concerned becomes a workplace which employs workers as those eligible for medical insurance prescribed in Article 4 (1) of the Act: Provided, That in cases where the execution of the business of medical insurance is deemed impossible due to poor business management or other special circumstances, the period for application for authorization of the establishment may be postponed pursuant to the provisions of the Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 15918, Oct. 17, 1998>

(2) Deleted. <by Presidential Decree No. 15918, Oct. 17, 1998>

Article 19(Establishment of Association by Order) #

The employer or the representative director of an association who is ordered to establish an association, etc. as prescribed in Article 17 (1) through (3) of the Act shall prepare the articles of association within one month and obtain the authorization of the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 20(Succession to Rights and Duties) #

The association established pursuant to the provisions of Article 19 shall succeed universally to the rights and duties of the association which was dissolved due to the establishment of the association concerned.

Article 21(Registration of Establishment) #

Matters for registration of the establishment of the association as prescribed in Article 19 of the Act shall be as follows:

1. Purpose and trade name;

2. Location of office;

3. Date of authorization of establishment;

4. Name and domicile of representative director; and

5. Where the power of the representative director is restricted, the restrictions on that power.

Article 22(Articles of Association) #

The articles of association shall record the following matters: <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

1. Purpose, name and location of the association;

2. Name and location of workplace;

3. Matters concerning the operating committee and the board of directors;

4. Matters concerning the officers, members of the operating committee and staff;

5. Matters concerning the insurance benefits;

6. Matters concerning the partial share of members of the association in bearing the expenses required for insurance benefits;

7. Matters concerning the premium;

8. Matters concerning the management of the surplus reserve and other properties; and

9. Method of public notice.

Article 23(Modification of Articles of Association not Requiring Authorization) #

The matters concerning the modification of the articles of association which do not require the authorization of the Minister of Health and Welfare pursuant to the proviso of Article 20 (1) of the Act shall be as follows: <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

1. Modification of the trade name or location of the association;

2. Addition or erasure of the workplace, or modification of the trade name or location of the workplace; and

3. Modification of the method of public notice.

Article 24(Appointment, etc. of Representative Director) #

(1) One representative director shall be appointed in the association; in cases falling under any of the following subparagraphs, he may hold a full-time position notwithstanding the provisions of Article 25 (1): <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

1. An association established pursuant to the provisions of Article 17 of the Act;

2. An association established at a workplace located in an industrial complex, etc.; and

3. Deleted. <by Presidential Decree No. 15918, Oct. 17, 1998>

(2) The full-time representative director of the association as prescribed in paragraph (1) 1 and 2 shall be elected by the consent of the majority of all members in the operating committee, following the eligibility standards and selection procedure as prescribed by the article of the association. In this case, the association concerned shall report to the Minister of Health and Welfare concerning the name, resident registration number, and career of the full-time representative director. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(3) Where the representative director is not elected within two weeks after authorization is given for the establishment of an association falling within the subparagraphs of paragraph (1), or within two weeks after the position of representative director of the association concerned becomes vacant, the Minister of Health and Welfare shall appoint a provisional representative director. In this case, the term of office of the provisional representative director shall be no more than three months. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(4) The representative director shall represent the association and preside over its affairs.

(5) The term of office of a representative director of association which falls within one of the subparagraphs of paragraph (1) shall be three years, and he may be reappointed only once.

(6) In case of accident to the representative director, another director shall execute those duties on his behalf pursuant to the provisions of the articles of association.

Article 25(Appointment, etc. of Director) #

(1) The directors shall be appointed on a part-time basis in the association; the fixed number shall be determined by the articles of association.

(2) The directors of the association shall be elected from among the members of the operating committee in the same number respectively by the members of the operating committee appointed by the members of the association who are employees and the members of the operating committee appointed by the employers. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(3) Deleted. <by Presidential Decree No. 15918, Oct. 17, 1998>

(4) The term of office of the directors shall be three years and they may be reappointed: Provided, That the term of office of the supplementary director shall be the remaining period of his predecessor’s term.

Article 26(Board of Directors) #

(1) The board of directors composed of directors shall be established in the association.

(2) The board of directors shall resolve the following matters:

1. Matters delegated by the operating committee;

2. Matters concerning the enforcement of a matter resolved by the operating committee;

3. Matters in respect of which the representative director requires urgent measures for business pursuant to the provisions of Article 37 (3); and

4. Other matters determined by the articles of association as matters concerning the operation of the association.

(3) Detailed matters concerning the operation of the board of directors of the association shall be determined by the articles of association.

Article 27(Appointment, etc. of Auditor) #

(1) The auditor shall be established on a part-time basis in the association; the fixed number of auditors shall be prescribed by the articles of association.

(2) The auditor shall be elected by the operating committee from among its members who are not directors.

(3) The term of the auditor shall be two years and he may be reappointed: Provided, That the term of office of a supplementary auditor shall be the remaining period of his predecessor’s term.

(4) The auditor shall audit the assets and inspect the circumstances of the business conduct of the association.

(5) Where the auditor discovers unjust matters with respect to the management of assets or the business conduct of the association, he shall report it to the operating committee.

Article 28(Operating Committee) #

(1) The operating committee shall be established in the association in order to resolve important matters of the association.

(2) The number of members of the operating committee shall be prescribed by the articles of association.

Article 29(Election of Members of Operating Committee) #

(1) The representative director shall be an ex officio member of the operating committee of the association; one-half of the members of the operating committee excluding the representative director shall be appointed by the employer from among members of the association, and the remaining one-half shall be mutually elected from among members of the association who are employees. <Amended by Presidential Decree No. 14850, Dec. 29, 1995; Presidential Decree No. 15918, Oct. 17, 1998>

(2) Deleted. <by Presidential Decree No. 15918, Oct. 17, 1998>

(3) The term of office of the members of the operating committee shall be three years, and they may be reappointed: Provided, That the term of office of a supplementary member of the operating committee shall be the remaining period of his predecessor’s term.

Article 30(Operating Committee Chairman) #

The representative director (including the provisional representative director) of the association as prescribed in the provisions of Article 24 shall be the chairman of the operating committee.

Article 31(Function of Operating Committee) #

(1) The operating committee shall resolve the following matters:

1. Matters concerning the approval of the budget and settlement of accounts;

2. Matters concerning the approval of business plans and business conduct reports;

3. Matters concerning the modification of the articles of association;

4. Matters concerning the organization of offices and their complement;

5. Matters concerning the surplus reserve and loans;

6. Matters concerning the management and disposition of the assets of the association;

7. Matters concerning the premium rates or premiums;

8. Matters concerning insurance benefits;

9. Matters concerning the designation and cancellation of a medical care institution; and

10. Other important matters concerning the operation of the association.

(2) The operating committee may, according to its resolutions, peruse documents regarding the business of the association, request the representative director to make reports, and otherwise audit the business conduct and circumstances of assets.

Article 32(Meeting of Operating Committee) #

(1) The meetings of the operating committee shall consist of regular meetings and extraordinary meetings.

(2) The regular meeting shall be convened by the chairman of the operating committee once or twice annually at the time determined by the articles of association.

(3) The extraordinary meeting shall be convened by the chairman of the operating committee when he deems it necessary.

(4) Where one third or more of all the members request the convening of a meeting, the chairman of the operating committee shall convene an extraordinary meeting within seven days from the date of that request.

(5) Notification of the convening of the extraordinary meeting of the operating committee as prescribed in the provisions of paragraphs (3) or (4) shall be given to the members of the operating committee at least three days prior to the opening of that meeting: Provided, That this shall not apply in cases of urgency.

(6) The chairman of the operating committee shall be the chairman of the meeting, and the meeting shall be opened upon the attendance of the majority of the members and issue resolutions by the consent of the majority of those members present: Provided, That matters concerning the modification of the articles of association shall be resolved by the consent of not less than two-thirds of all members of the operating committee.

(7) Except as otherwise determined by the articles of association, a member of the association may observe meetings of the operating committee.

Article 33(Restrictions on Qualifications of Officers and Members of Operating Committee) #

An officer who is dismissed or a member of the operating committee whose commission is cancelled pursuant to the provisions of Article 23 of the Act shall not become an officer or member of the operating committee of the association for two years from the date of the dismissal or cancellation of commission.

Article 34(Office Organization and Complement of Association) #

The office organization and complement of the association shall be determined by the representative director of the association upon the approval of the Minister of Health and Welfare, on the basis of the scale of the association and according to the criterion determined by the Minister of Health and Welfare: Provided, That in case of an association which does not fall within Article 24 (1) 1 and 2, the organization and complement shall be determined upon the approval of the Special Metropolitan City Mayor, Metropolitan City Mayor or Do governor (hereinafter referred to as the “Mayor/Do governor”). <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 14850, Dec. 29, 1995; Presidential Decree No. 15918, Oct. 17, 1998>

Article 35(Employment of Association Staff) #

(1) Except as otherwise provided by the Minister of Health and Welfare, where the representative director of the association employs the staff, this shall be done in principle by means of an open competitive examination or a restricted competitive examination. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) Among the examinations as prescribed in paragraph (1), the written examination shall be conducted by the president of the Medical Insurance Federation according to the request of the association, and the detailed matters necessary for the exam shall be determined separately by the president of the Medical Insurance Federation.

Article 36(Exchange of Personnel between Associations) #

(1) Where the Minister of Health and Welfare deems it necessary for the balanced placement and efficient use of the human resources of the association, he may formulate a personnel exchange plan and require the representative director of the association to execute the exchange of personnel between associations. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) A person who is shifted due to the personnel exchange shall be treated in a manner corresponding to the position transfer, and his employee retirement benefits allowance shall be managed through the accounts between associations.

(3) Other matters necessary for the exchange of personnel between associations shall be determined by the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 37(Business Conduct of Association) #

(1) Unless particularly prescribed by the articles of association, the business of the association shall be conducted upon the attendance of the majority of the directors and by the consent of the majority of directors present.

(2) Where the meeting of the operating committee does not take place or cannot be convened in cases of urgency in respect of the settlement of matters which the operating committee ought to resolve, the representative director may settle the matters to be resolved by the operating committee without its resolution.

(3) Where the representative director has settled the business of the association pursuant to the provisions of paragraph (2), he shall without delay convene a meeting of the operating committee and report this fact.

Article 38(Vicarious Execution of Duties of Representative Director) #

The employer which established the association pursuant to the provisions of Article 16 of the Act shall execute the duties of a representative director until the representative director is appointed. The same shall also apply in respect of the representative director of the association who is given the order to establish pursuant to the provisions of Article 17 (2) or (3) of the Act. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 39(Public Notice) #

(1) Where the association has been established, the representative director of the association shall issue public notice of the articles of association without delay. The same shall also apply in the case of modification of the articles of association.

(2) Where the members of the operating committee or the directors of association have been appointed, the representative director of the association shall issue public notice without delay. The same shall apply in the case of modifications to the members of the operating committee or the directors.

(3) The representative director of the association shall issue public notice of the statement of accounts and the property inventory as prescribed in the provisions of Article 50 (2) within fourteen days from the date they have received the resolution of the operating committee.

Article 40(Reimbursement of Actual Expenses) #

The members of the operating committee or the director of the association may receive reimbursement for actual expenses from the association pursuant to the provisions of the articles of association.

Article 41(Keeping of Articles of Association, etc.) #

(1) The association shall keep in its office the articles of association, property inventory, register of membership of association, minutes of meetings of the operating committee and board of directors, and other documents as determined by the Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) Where the members of the association require the perusal of documents as prescribed in paragraph (1), the representative director shall not refuse that request in the absence of justifiable reasons.

Article 42(Fiscal Year) #

The fiscal year of the association shall correspond to the fiscal year of the government.

Article 43(Budget) #

The association shall draw up a draft budget for each fiscal year divided into sections according to the nature of its contents, and obtain the approval of the Minister of Health and Welfare. The same shall also apply in the case of modifications to the budget. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 44(Reserve Funds) #

In order to appropriate expenditures outside or in excess of the budget which could not be anticipated, the association shall earmark reserve funds of an amount equivalent to three percent (3/100) or more of the budget amount for the year concerned.

Article 45(Loans of Association) #

(1) Where deficiencies occur in the cash expenditure of the association, the association may take out a temporary loan upon the approval of the Minister of Health and Welfare. In this case, the association shall report to the Minister of Health and Welfare, without delay, about the contents of loans. <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 15918, Oct. 17, 1998>

(2) The temporary loan as prescribed in the provisions of paragraph (1) shall be redeemed during the fiscal year concerned: Provided, That this shall not apply in respect of funds loaned pursuant to the provisions of Article 27 (4) 2 of the Act.

Article 46(Surplus Reserve) #

(1) The association shall accumulate out of the surplus funds in the settlement of accounts of each fiscal year, an amount equivalent to five percent (5/100) or more of the average yearly amount of expenses (where it does not amount to five percent [5/100] of the average yearly amount of surplus funds, that total amount) required for insurance benefits for the three years prior to that year (in cases where three years has not elapsed since the establishment of the association, an amount equal to twelve times the average monthly amount after establishment) as the surplus reserve until it reaches the average yearly amount.

(2) The surplus reserve under paragraph (1) may be used only in the case of appropriation for deficiencies in the expenses required for insurance benefits or substitute use pursuant to the provisions of Article 47.

Article 47(Substitute Use of Surplus Reserve) #

(1) The association may use the surplus reserve as a substitute where deficiencies occur in cash expenditure.

(2) The amount of money used in substitution pursuant to the provisions of paragraph (1) shall be returned during the fiscal year concerned.

Article 48(Surplus Funds in Settlement of Accounts) #

In cases where surplus funds in the settlement of accounts have arisen in each fiscal year, the association shall carry it forward to the next fiscal year or accumulate it as an accumulated amount for the medical insurance business pursuant to the provisions of the Minister of Health and Welfare, with the exception of the amount of money which is to be reserved as the surplus reserve according to the provisions of Article 46. <Amended by Presidential Decree No. 14850, Dec. 29, 1995>

Article 49(Disposition, etc. of Basic Properties) #

(1) Where the association intends to acquire, transfer, exchange or offer as security the basic properties of the association, it shall obtain the approval of the Minister of Health and Welfare.

(2) The association may lease part of the building or building site used for business.

[This Article Wholly Amended by Presidential Decree No. 14850, Dec. 29, 1995]

Article 50(Business Report) #

(1) The representative director of the association shall, upon preparing the statement of settlement of accounts in each fiscal year, report to the operating committee within two months from the expiration of that year and obtain its resolution.

(2) The representative director shall attach the property inventory prepared as of the end of the year to the statement of settlement of accounts which has been resolved pursuant to the provisions of paragraph (1), and report it to the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 51(Operational Regulations of Association) #

(1) The Minister of Health and Welfare shall determine operational standing rules concerning the organization, personnel, remuneration and accounting, etc. of the association in order for the smooth and efficient operation of the association.

(2) The association shall keep detailed operational regulations concerning the organization, personnel, remuneration and accounting, etc. of each particular association based on the operational standing rules prescribed in paragraph (1).

Article 52(Liquidation of Association) #

Where the association is dissolved, the representative director of that association shall be the liquidator except in the case of bankruptcy: Provided, That in cases where there is no representative director or where the representative director is unsuitable to become liquidator, the Minister of Health and Welfare shall appoint a liquidator. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 53(Merger of Associations) #

Where two or more associations intend to merge, the representative directors of the associations concerned shall jointly prepare the articles of association for the association which continues to exist after the merger or which is established as a result of the merger, and shall obtain the authorization of the Minister of Health and Welfare. In this case, the consent of three-quarters or more of all the members of the operating committees of the associations concerned shall be required in relation to that merger. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 54(Business of Medical Insurance Federation) #

(1) The Medical Insurance Federation (hereinafter referred to as the “Federation”) as prescribed in Article 27 of the Act shall conduct the following business: <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

1. Insurance financing stability projects, and the establishment and operation of medical or welfare facilities as prescribed in the provisions of Article 27 (2) of the Act;

2. Business concerning the designation and cancellation of medical care institutions as prescribed in the provisions of Articles 32 and 33 of the Act;

3. Business concerning the examination and payment of expenses of insurance benefits which the insurer has entrusted to the Federation pursuant to the provisions of Article 35 (3) of the Act;

4. The direction and supervision in respect of associations which has been entrusted to the Federation by the Minister of Health and Welfare pursuant to the provisions of Article 81 (2) of the Act;

5. Management of residual property (limited to property in respect of which disposition has been entrusted to the Federation pursuant to the articles of association) of the dissolved association;

6. Education, training and publicity concerning medical insurance;

7. Investigation, research and international cooperation concerning medical insurance; and

8. Business which has been entrusted in relation to the examination and payment of medical care expenses paid pursuant to the provisions of other Acts.

(2) The Federation may take the measures necessary regarding its business in respect of the association in order to perform the business as prescribed in paragraph (1). <Newly Inserted by Presidential Decree No. 14850, Dec. 29, 1995>

Article 55(Articles of Federation) #

In the articles of the Federation, the following matters shall be prescribed: <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

1. Purpose;

2. Name and location;

3. Matters concerning the qualifications, admission and withdrawal of members;

4. Matters concerning assets and accounting;

5. Matters concerning the general meeting and board of directors;

6. Matters concerning the officers and staff;

7. Matters concerning the collection of membership dues;

8. Method of public notice;

9. Matters concerning the modification of the articles of the Federation;

10. Matters concerning the insurance financing stability projects as prescribed in the provisions of Article 27 (2) of the Act; and

11. Other important matters concerning the Federation.

Article 56 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 57(Matters for Resolution by General Meetings) #

The general meeting of the Federation shall resolve the following matters: <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

1. Matters concerning the election of officers (excluding full-time directors and full-time auditors);

2. Matters concerning the approval of budgets and settlement of accounts;

3. Matters concerning the approval of business plans and reports on business performance results;

4. Matters concerning the modification of the articles of the Federation;

5. Matters concerning the management and disposition of principal assets;

6. Matters concerning membership dues and other charges;

7. Matters concerning the management and operation of insurance financing stability funds; and

8. Other important matters concerning the operation of the Federation.

Article 58(Officers of Federation) #

(1) The president, vice-president, director and auditor shall be assigned as officers in the Federation; the fixed number shall be prescribed by the articles of the Federation.

(2) The president shall hold a full-time position and be elected by the general meeting with the approval of the Minister of Health and Welfare obtained. <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 15918, Oct. 17, 1998>

(3) The vice-president shall hold a part-time position and be elected by the general meeting from among the representative directors of the associations [where the National Medical Insurance Management Corporation (hereinafter referred to as the “corporation”) becomes a member, the officers of the corporation shall be included; hereinafter in paragraph (5) the same shall apply]. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(4) The full-time director and full-time auditor shall be appointed by the president with the consent of the board of directors; the approval of the Minister of Health and Welfare shall be obtained. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(5) The part-time director and the part-time auditor shall be elected by the general meeting from among the representative directors of the associations. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 59(Term of Office of Officers of Federation) #

(1) The term of office of the president, vice-president and director of the Federation shall be three years respectively and the term of office of the auditor shall be two years; they may be reappointed or reelected.

(2) The term of office of the supplementary officer shall be the remaining period of his predecessor’s term.

Article 60(Duties, etc. of Officer of Federation) #

(1) The president shall represent the Federation and preside over the business of the Federation.

(2) The vice-president shall assist the president and, in case of, shall execute those duties on his behalf pursuant to the provisions of the articles of accident to the president, the Federation.

(3) The full-time director shall conduct the business of the Federation in accordance with the orders of the president.

(4) The auditor shall audit the accounting, business conduct and circumstances of properties of the Federation.

Article 61(Board of Directors of Federation) #

(1) A board of directors shall be established in the Federation in order to deliberate on the matters delegated by the general meeting and important matters concerning the conduct of business. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(2) The board of directors of the Federation shall be composed of the president, the vice-president and the directors; matters concerning the operation, etc. of the board of directors shall be prescribed by the articles of the Federation.

Article 62(Medical Care Expense Review Committee) #

(1) The Medical Care Expense Review Committee shall be established in the Federation in order to effectively conduct the business concerning the review and payment of insurance benefits expenses under the provisions of subparagraph 3 of Article 54 and the entrusted business concerning the review and payment of medical care expenses under the provisions of subparagraph 8 of the same Article.

(2) The Medical Care Expense Review Committee shall consist of no more than 15 full-time review members including the chairman, and no more than 500 part-time review members. <Amended by Presidential Decree No. 14850, Dec. 29, 1995>

(3) The chairman and the full-time review members shall be appointed by the president of the Federation upon the approval of the Minister of Health and Welfare, and the part-time review members shall be commissioned by the president of the Federation from among the persons recommended by the medical and pharmaceutical related association, pursuant to the determinations of the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(4) The qualifications and term of office of review members and other matters necessary with respect to the operation of the Medical Care Expenses Review Committee shall be prescribed by the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 63(Receipt of Commission for Review) #

Where the Federation has been entrusted with the review of medical care expenses, it may receive a financial commission from the entruster concerned pursuant to the determinations of the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 64(Collection, etc. of Charges) #

(1) The charges which the Federation collects from the associations and the Corporation pursuant to the provisions of Article 27 (3) of the Act shall be the amount prescribed with the approval of the Minister of Health and Welfare within the limit of twenty-five percent (25/100) of the insurance premium revenue of the associations and the Corporation. <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 14850, Dec. 29, 1995>

(2) Matters necessary with respect to the calculation criterion and method of collection, etc. of the charges prescribed under paragraph (1) shall be determined by the Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 65(Joint Liability Projects, etc.) #

The projects prescribed in the provisions of Article 27 (4) 1 of the Act shall be the projects determined by the Federation with the approval of the Minister of Health and Welfare from among the following projects: <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

1. Joint liability projects for high insurance benefits expenses;

2. Joint liability projects for medical expenses of the aged;

3. Preventive health projects for the promotion of national health and the curtailing of medical expenses; and

4. Support projects for insurers in financial difficulties due to natural disasters, etc.

Article 66(Management and Operation of Insurance Financing Stability Project Funds) #

The funds required for the insurance financing stability projects (hereinafter referred to as the “funds”) prescribed in the provisions of Article 27 (2) of the Act shall be managed and operated by the Federation.

Article 67(Creation of Funds) #

The Funds shall be created out of the following financial resources:

1. Charges as prescribed in Article 64;

2. Government subsidies as prescribed in Article 80;

3. Proceeds accruing from the operation of the funds; and

4. Miscellaneous revenues.

Article 68(Formulation of Plan for Management and Operation of Funds) #

(1) In order to manage and operate the funds effectively, the Federation shall formulate a plan for the management and operation of the funds and obtain the approval of the Minister of Health and Welfare up until two months prior to the commencement of the following fiscal year. The same shall apply where alterations to the plan are intended. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) The plan for the management and operation of the funds as prescribed in paragraph (1) shall include the following matters:

1. Matters concerning the revenue and expenditure of the funds;

2. Matters concerning business plans, expenditure-incurring conduct and capital scheme for the year concerned;

3. Matters concerning the disposal of money brought forward from the previous year;

4. Matters concerning the accumulated amount; and

5. Other matters necessary for the management and operation of the funds.

Article 69(Accounting of Funds) #

(1) The fiscal year of the funds shall be in accordance with the fiscal year of the government.

(2) Accounting in respect of the funds shall take place separately from other accounting of the Federation.

Article 70(Statement of Settlement of Accounts of Funds) #

The Federation shall annually prepare a statement of the settlement of accounts of the funds for the year concerned and submit it to the Minister of Health and Welfare within two months from the expiration of the year concerned. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 71(Accounting Institution, etc. for Funds) #

The Federation shall determine the accounting institution, method of receipt and other matters necessary with respect to the operation of the Fund, with the approval of the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 72(Continuing Expenditure) #

Where it is necessary to expend money continuously for more than one fiscal year in order to establish medical or welfare facilities, the Federation may fix a period and earmark the continuing expenditure in the budget upon the resolution of the general meeting. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 73(Loans of Federation) #

(1) In cases where it is deemed necessary in order to establish medical or welfare facilities, the Federation may obtain loans for the capital required.

(2) Where the Federation intends to obtain loans pursuant to the provisions of paragraph (1), it shall obtain the approval of the Minister of Health and Welfare through the resolution of the general meeting with respect to the method of borrowing, interest rates, method of redemption, etc. <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 15918, Oct. 17, 1998>

Article 74(Organization, etc. of Federation) #

Where the Federation issues regulations with respect to its internal organization, the appointment and dismissal of staff, the remuneration of officers and staff, the management and operation of medical or welfare facilities, etc., it shall obtain the approval of the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 75(Personal Liability for Expenses) #

(1) Among the medical care benefits and delivery benefits under Article 34 (1) of the Act, the proportion and amounts of expenses which the person in question shall bear shall be as shown in Table 1. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(2) Deleted. <by Presidential Decree No. 15918, Oct. 17, 1998>

(3) The amount of personal liability for expenses prescribed in the provisions of paragraph (1) shall be paid by the insured or their dependants to the medical care institution, pursuant to the request of the medical care institution. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(4) The provisions of paragraphs (1) and (3) shall apply mutatis mutandis in respect of persons who receive insurance benefits pursuant to the provisions of Article 38 or 39 of the Act. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 75-2(Period of Insurer’s Liability for Medical Care Benefits) #

The medical care benefits period during which the insurer bears the expenses pursuant to the provisions of the text of Article 30 (1) of the Act shall be three hundred and thirty days per annum. <Amended by Presidential Decree No. 15374, May 22, 1997; Presidential Decree No. 15918, Oct. 17, 1998>

[This Article Newly Inserted by Presidential Decree No. 14850, Dec. 29, 1995]

Article 76(Limitation on Refund of Person Liability Monies Paid in Excess) #

The amount, which may be chosen not to be returned under the proviso of Article 35 (2) of the Act, shall be less than 1,000 won.

[This Article Wholly Amended by Presidential Decree No. 15918, Oct. 17, 1998]

Article 76-2(Medical Examination) #

(1) The insured as prescribed in Article 39-2 (1) of the Act shall be the insured under this Act. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(2) The insurer shall conduct medical examinations once every two years in respect of the insured engaged in clerical work, and once every year in respect of other insured pursuant to the provisions of Article 39-2 (2) of the Act.

(3) Medical examination under paragraph (2) shall be conducted in the health and medical institutions that are equipped with relevant manpower and equipment as prescribed by the Ordinance of the Ministry of Health and Welfare. <Newly Inserted by Presidential Decree No. 15918, Oct. 17, 1998>

(4) Where the insurer intends to conduct medical examinations, he shall, during January every year, inform the employer of the workplace to which the insured belongs of the medical examination implementation plan.

(5) The employer of the workplace informed pursuant to paragraph (4) shall take measures necessary to enable the insured to receive the medical examination. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(6) The medical care facilities which conducted the medical examination shall inform the employer of the workplace and the association to which the insured belongs respectively, of the results of the medical examination. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(7) Necessary matters regarding the method and contents of the medical examination and the expenses required therefor shall be determined by the Minister of Health and Welfare. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

[This Article Newly Inserted by Presidential Decree No. 14850, Dec. 29, 1995]

Article 77(Additional Benefits) #

(1) The additional benefits as prescribed in the provisions of Article 40 of the Act means funeral expenses, maternity allowances and personal liability compensation monies.

(2) Funeral expenses shall be paid in the case of the death of the insured or their dependants; the amount to be paid shall be prescribed by the articles of association.

(3) Maternity allowances shall be paid in cases where the insured or their spouses give birth to a child; the amount to be paid shall be prescribed by the articles of association.

(4) Personal liability compensation shall be paid where the amount of personal liability exceeds 500 thousand won per month (including where the amount exceeds 500 thousand won within a period of one month), and the amount to be paid shall be determined by the articles of the association within the limit of the excess. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 78 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 79 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 80(State Liability) #

(1) Expenses necessary for the operation of medical insurance projects which may be borne by the national treasury pursuant to the provisions of Article 48 of the Act shall be as follows:

1. Office expenses of medical insurance projects;

2. Expenses required for the payment of insurance benefits; and

3. Expenses for the creation of financial resources of funds.

(2) The part of the expenses to be borne by the national treasury as prescribed in the provisions of paragraph (1) and its criterion shall be determined annually by the Minister of Health and Welfare within the limits of the budget. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 81(Standard Monthly Remuneration Amount) #

The standard monthly remuneration amount according to the grade of the insured as prescribed in Article 50 of the Act shall be as shown in Table 2. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 82(Determination of Standard Monthly Remuneration Amount at time of Acquisition of Qualifications as the Insured) #

Where a person has acquired the qualifications of the insured, the insurer shall regard the amount based on the following classifications as the monthly remuneration amount of the insured and determine the standard monthly remuneration amount in accordance with Table 2: <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

1. In cases where the remuneration is determined on monthly or weekly basis or on the basis of some other specified period, the amount equivalent to 30 times that remuneration amount divided by the total number days during that period;

2. In cases where the remuneration is determined on daily or hourly basis, or according to output or contract for work, the average amount of remuneration which another person engaged in the same business as the insured concerned and receiving the same remuneration at the workplace concerned received for the period of one month prior to the month when the insured acquired his qualifications; and

3. In the case of a person whose monthly remuneration amount is difficult to calculate in accordance with subparagraphs 1 and 2, the average amount of remuneration which another person engaged in the same business received for the period of one month prior to the month when the insured acquired his qualifications.

Article 83(Modification of Standard Monthly Remuneration Amount) #

(1) In cases where the standard monthly remuneration amount equivalent to the total amount of remuneration received by the insured from that workplace continuously for three months (provided that the number of days forming the basis of remuneration payment is not less than 20 days per month) divided by the number of months concerned, differs by two grades or more from the standard monthly remuneration amount which currently applies to that person, the insurer shall modify the standard monthly remuneration amount from the month following the month in which that difference is made. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(2) Notwithstanding the provisions of paragraph (1), in cases where the difference between the standard monthly remuneration amount which currently applies to the insured and that which he receives has been made due to an increase in remuneration, promotion or advancement, the insurer shall modify the standard monthly remuneration amount from the month in which that difference arose. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

Article 84(Special Case of Determination of Standard Monthly Remuneration Amount) #

(1) Where it is difficult to calculate the standard monthly remuneration amount for the insured pursuant to the provisions of Article 82 or where the amount calculated pursuant to the provisions of Article 82 or 83 is obviously unreasonable, the insurer shall calculate the standard monthly remuneration amount notwithstanding those provisions. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(2) The method for calculating the standard monthly remuneration amount as prescribed in the provisions of paragraph (1) shall be determined by the articles of association.

Article 85(Equivalent Value of Remuneration in Kind) #

In cases where all or part of the remuneration is paid in kind, the estimated value shall be determined by the insurer on the basis of the current price in that district. <Amended by Presidential Decree No. 14850, Dec. 29, 1995>

Article 86 #

Deleted.<by Presidential Decree No. 15918, Oct. 17, 1998>

Article 87(Premium Rate in respect of Insured Overseas) #

The premium rate which is to apply in respect of the insured who is engaged in business overseas pursuant to the provisions of Article 51 (2) of the Act shall be prescribed by the articles of association within the limit of 80 percent (80/100) of the premium rate which an affiliated association applies to the other insured engaged in a domestic workplace.

Article 88(Commission, etc. of Members) #

(1) The members of the Medical Insurance Appeal Committee (hereinafter referred to as the “Appeal Committee”) as prescribed in the provisions of Article 63 of the Act shall be persons recommended from the organizations concerned, etc. at the request of the head of the organization of insurers in accordance with the following classifications, who are commissioned or appointed by the head of the organization of insurers: <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

1. Members representing the insured: two persons recommended by the labor union and one person recommended by the consumer protection organization (in cases where the associations establish the Appeal Committee separately, three persons recommended by the operating committee of the association from among the insured);

2. Members representing the employers: three persons recommended by the employers’ association;

3. Members representing the medical and pharmaceutical circles: three persons recommended by the medical and pharmaceutical affairs related organization; and

4. Members representing the insurers: four persons recommended by the head of the organization of insurers.

(2) The members of the Medical Insurance Reappeal Committee (hereinafter referred to as the “Reappeal Committee”) as prescribed in the provisions of Article 63 of the Act shall be persons recommended from the organizations concerned, etc. at the request of the Minister of Health and Welfare in accordance with the following classifications, who are commissioned or appointed by the Minister of Health and Welfare: <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 15732, Feb. 28, 1998>

1. Members representing the insured: one person respectively recommended by the labor unions, the teachers’ related organization and the consumer protection organization;

2. Members representing the employers: one person respectively recommended by the employers association, the private schools managers association and the Minister of Government Administration and Home Affairs;

3. Members representing the medical community: three persons recommended by the medical related organization;

4. Members representing the insurers: two persons recommended by the president of the Federation, and one by the chief director of the Corporation; and

5. Members representing the public interest: four persons from among Grade Ⅳ or higher public officials attached to the Ministry of Health and Welfare who are in charge of the duties relating to medical insurance and persons with great knowledge and experience with respect to medical insurance.

Article 89(Jurisdiction of Appeals) #

(1) An appeal claim shall be submitted to the Appeal Committee established in the organization of insurers. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>

(2) In cases where the jurisdiction in respect of an appeal claim is unclear or in dispute, the Appeal Committee designated by the Minister of Health and Welfare shall have jurisdiction over it. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(3) Where the appeal claim is in violation of jurisdiction, the Appeal Committee which received it shall transfer the case to the Appeal Committee with jurisdiction and inform the person who submitted the appeal claim (hereinafter referred to as the “applicant”) of the reasons for the transfer in writing.

(4) The transferred case shall be regarded as an appeal claim made to the Appeal Committee to which it was transferred from the time that it was first received.

Article 90(Notice to Insurers, etc.) #

Where the Appeal Committee (including the Reappeal Committee; hereinafter the same shall apply) takes up a written appeal claim (including a written reappeal claim; hereinafter the same shall apply), the Appeal Committee shall notify the insurer concerned and other interested persons of this fact and provide a duplicate or copy of the written appeal claim.

Article 91(Allowance, etc.) #

The members and the experts concerned who attend meetings of the Reappeal Committee may be paid allowances, daily wages, lodging charges or traveling expenses within the limits of the budget: Provided, That this shall not apply in cases where members who are public officials attend in direct connection with their official business.

Article 92(Imposition and Collection of Penalty) #

(1) Where the Minister of Health and Welfare intends to impose a penalty pursuant to the provisions of Article 77 (2) and (3) of the Act, he shall clearly state the classification of the conduct in violation and the penalty amount in written form and notify that it is to be paid. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) The estimated amount and procedure for collection of penalties shall be determined by the Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 93 #

Deleted.<by Presidential Decree No. 15598, Dec. 31, 1997>

Article 94(Delegation and Entrusting, etc. of Authority) #

(1) The Minister of Health and Welfare shall delegate the following authority to the Mayor/Do governor with jurisdiction over the location of the main office of the association pursuant to the provisions of Article 81 (1) of the Act: <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 14850, Dec. 29, 1995; Presidential Decree No. 15918, Oct. 17, 1998>

1. The authority, pursuant to the provisions of Article 17 (3) of the Act, to order the employer of a workplace who intends to establish an association as prescribed in Article 16 of the Act to join with another association already established (limited to cases where the same Mayor/ Do governor has jurisdiction over the location of the main office of the association already established and the location of the workplace which intends to establish an association);

2. The authority under the provisions of Article 23 of the Act on the cancellation of resolutions adopted by the association and the dismissal of officers of the association;

3. The authority, prescribed in the provisions of Article 56 (3) of the Act, with respect to the approval of dispositions of premiums or other charges in arrears;

4. The authority of the Minister of Health and Welfare concerning the provisions of Article 76 of the Act;

5. The authority with respect to supervision of associations as prescribed in the provisions of Article 80 of the Act;

6. Deleted; and <by Presidential Decree No. 15918, Oct. 17, 1998>

7. Matters concerning the approval of the drafting and modification of the budget as prescribed in Article 43 (excluding the first year of establishment), the acceptance of reports on contents of loans as prescribed in Article 45 (1), the approval of disposition of principal properties as prescribed in Article 49 (1), the acceptance of the statement of settlement of accounts as prescribed in Article 50 (2).

(2) The Minister of Health and Welfare shall entrust the following activities to the Federation pursuant to the provisions of Article 81 (2) of the Act: <Amended by Presidential Decree No. 14446, Dec. 23, 1994; Presidential Decree No. 14850, Dec. 29, 1995>

1. To demand the submission of documents related to the review of insurance benefits expenses with respect to the medical care institution as prescribed in the provisions of Article 76 (2) of the Act;

2. To issue instructions in respect of the business reports and the inspection of the business and property situation of the association as prescribed in the provisions of Article 80 of the Act; and

3. To undertake management analysis and evaluation in respect of the business and operations of the association as prescribed in the provisions of Article 80 of the Act.

(3) Where the president of the Federation deems it necessary to confirm the authenticity of documents submitted or notified pursuant to the provisions of paragraph (2) 1, he may dispatch staff under his authority to conduct on-the-spot investigations to confirm the matters concerned.

Article 95(Entrusting of Operations) #

(1) Where the association intends to entrust postal service offices or financial institutions with operations regarding the receipt of premiums and payment of insurance benefits expenses pursuant to the provisions of Article 82 (1) of the Act, the association shall go through the resolutions of the operating committee of the association concerned with respect to the appointment of the institution to be entrusted and the details of the entrusting contract. <Amended by Presidential Decree No. 15374, May 22, 1997>

(2) and (3) Deleted. <by Presidential Decree No. 15918, Oct. 17, 1998>

Article 96(Insured Foreigners) #

A foreigner who may become the insured pursuant to the provisions of Article 83 (2) of the Act shall be an employee who works in the workplace which hires not less than five ordinary employed workers (excluding foreigners).

[This Article Wholly Amended by Presidential Decree No. 15918, Oct. 17, 1998]

Article 97(Imposition and Collection of Fines for Negligence) #

(1) Where the Minister of Health and Welfare intends to impose a fine for negligence pursuant to the provisions of Article 90 (1) of the Act, he shall, after investigating and confirming the offense, notify the person subject to the disposition of the fine for negligence, clearly stating in writing the type of offense, amount of the fine for negligence, term of payment, etc. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(2) Where the Minister of Health and Welfare desires to impose a fine for negligence pursuant to the provisions of paragraph (1), he shall give the person subject to the disposition of the fine for negligence the opportunity to state his opinion orally or in writing within a fixed period of ten days or more. In this case, if there has been no statement of opinion by the designated date, it shall be deemed that there is no opinion. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(3) In determining the amount of the fine for negligence, the Minister of Health and Welfare shall take into consideration the motive and consequences, etc. of the offense concerned. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

(4) The procedures for the collection of the fine for negligence shall be determined by the Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 98(Report on Operations) #

The Mayor/Do governor shall, in accordance with the Ordinance of the Ministry of Health and Welfare, report on the operational situation of the association to the Minister of Health and Welfare. <Amended by Presidential Decree No. 14446, Dec. 23, 1994>

Article 99(Provisions Applicable Mutatis Mutandis to Federation) #

The provisions of Articles 21, 32, 33, 37 (2) and (3), 39, 40, 42 through 45, 49, 50 and 52 shall apply mutatis mutandis with respect to the Federation. In this case, “association” shall be regarded as “Federation”, “operating committee” as “general meeting”, “chairman of the operating committee” as “chairman of board of representatives” (in case of Article 32 (2) through (4), it refers to the president of the Federation), “representative director” as “president of the Federation”, and “members of the operating committee or members of the association” as “members of the Federation”. <Amended by Presidential Decree No. 15918, Oct. 17, 1998>